Breast Reconstruction Risks

Post-mastectomy breast reconstruction with implants or any of the flap techniques can provide cosmetically satisfying results. However, all breast cancer reconstruction procedures carry a degree of risk, so a potential candidate should carefully explore her options and consult with a qualified cosmetic surgeon before making the decision to have reconstructive surgery.

Risks of Breast Reconstruction with Implants

The risks of breast cancer reconstruction with implants are much the same as breast augmentation risks in general. All breast implants rupture eventually. Saline breast implants deflate rapidly after they develop a leak, which typically requires immediate removal and replacement. Silicone breast implants can slowly leak silicone into the surrounding tissue for an extended time period before the woman becomes aware that there is a problem. Capsular contracture, an accumulation of scar tissue around an implant, can make the reconstructed breast feel hard. A breast implant can shift, producing an unnatural look and requiring corrective surgery. Breast implants can temporarily or permanently alter the sensation of the breast or nipple. And the possibility always exists that a woman will be dissatisfied with the results of her breast reconstruction surgery with implants. Any woman who is considering breast implants for breast cancer reconstruction should understand the risks and should have reasonable expectations for the final results. A reconstructed breast will differ in shape and firmness from the other breast. However, this difference will only be noticeable to the woman and her intimate partner. Most women who undergo a mastectomy find that breast reconstruction surgery provides excellent aesthetic improvement, and enhances self-esteem and quality of life.

Risks of Flap Breast Reconstruction Techniques

Flap breast reconstruction involves surgically moving living tissue to the chest from another part of the body to recreate a breast that has been lost in a mastectomy. TRAM flap breast cancer reconstruction involves removing skin, fat, and muscle tissue from the abdomen. DIEP flap breast reconstruction surgery is similar to TRAM flap surgery, but in DIEP flap reconstruction surgery, only skin and fat are taken from the abdomen. In latissimus dorsi flap breast reconstruction surgery, tissue from the upper back is moved to reconstruct the breast. In a gluteal flap breast cancer reconstruction procedure, tissue from the lower buttock is used.

As with breast implant reconstruction, women who are considering flap breast reconstruction should have reasonable expectations for the outcome of the surgery. Flap breast cancer reconstruction can restore size and contour, but it will not result in a breast that looks likes the breast it replaces. Furthermore, the new breast will not have the sensations and feeling of a natural breast. Because TRAM flap surgery takes muscle tissue from the abdomen, abdominal strength is temporarily reduced after the surgery, and there is a risk of prolonged discomfort in the abdominal area. With DIEP flap surgery, there is a greater risk that the blood supply to the moved tissue will be inadequate, possibly requiring removal of the tissue. Latissimus dorsi flap breast cancer reconstruction surgery inevitably results in visible asymmetry to the back, and because the back skin has different color and texture from breast skin, the cosmetic results may not be as pleasing as other procedures.

All flap breast reconstruction surgeries result in scarring, and all carry the risk that the relocated tissue will fail to "take" and will die. A relatively rare occurrence, tissue death, or necrosis, typically happens soon after surgery, and necessitates removal of the transplanted tissue.

Breast Cancer Reconstruction – Long-Term Concerns

Immediately after a breast cancer reconstruction procedure, most patients are happy to be cancer-free and to once again have both breasts. However, there are some long-term concerns after the initial recovery from breast reconstruction surgery. All patients need to be aware that reconstructed breasts will not have the same feel or exact look of their natural breasts. Scars from post-mastectomy breast reconstruction may fade over time, but they will never completely disappear. A period of emotional adjustment may be necessary to become accustomed to the loss of the breast and the newly constructed breast.

Studies have shown that breast implants are safe in the long term when used in breast cancer reconstruction surgery. In fact, some research indicates that breast implants may actually impede the recurrence of breast cancer. Reconstruction surgery with implants sometimes does not give a woman the results she expected, however. In such cases, breast implant revision is an effective and relatively simple solution. The implant or implants can be removed and exchanged for a different type or size, or the implants can simply be removed. The U.S. Food and Drug Administration recommends that women who have silicone breast implants have an MRI three years after receiving an implant and every two years hence to ensure detection if a leak occurs. If a silicone or saline breast implant ruptures, breast implant replacement surgery will be necessary.

Although breast reconstruction surgery may result in one breast having a slightly different shape and feel than the other breast, most patients who have had post-mastectomy breast reconstruction feel that these differences do not diminish the satisfaction with their replacement breast. Most women report that their self-esteem and confidence improve after a breast cancer reconstruction procedure, and that they are glad that they had the surgery.

Locate a Cosmetic Surgeon in Your Area

Breast reconstruction surgery offers an effective solution for mastectomy patients to cosmetically replace a breast lost to cancer. Because there are risks and possible complications with breast reconstruction procedures, if you are considering breast reconstruction surgery, you should choose a breast reconstruction surgeon who will help you understand your options and select the procedure that will provide you the most benefit. DocShop can help you find a highly qualified cosmetic surgeon in your area so that you can learn more about breast cancer reconstruction, its risks and benefits, and what procedure will be best for you.